Wednesday 20 July 2011Session jointly convened by LSHTM/SHARE,

WSSCC, UNICEF and WSP

Global Scaling Up Hand washing Project -Tanzania Experience

Nyanzobe Hamisi Malimi, WSP

Making ‘what works’ work: Changing behaviour in sanitation and hygiene

Working with national government and 10 districts to learn how to prompt households to improve and maintain their hand washing behaviours.

Implementation 2009-2011: Scaling up and hand washing with soap at critical junctures

Program snapshot

Why Tanzania investing in hand washing?

• 30,000 people die annually due to diarrheal diseases.

• 12.6 percent of children suffer from diarrheal diseases.

• Acute respiratory infections (ARIs), an average prevalence of 8% (DHS, 2004-05 report).

• Knowledge of the reasons to wash hands was high but the practice was low.

• Hand washing with soap can reduce diarrheal incidence by 42-47% (Curtis and Cairncross 2003)

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Who are we talking to?

Rural Mothers and caretakers of children under five years old.

• Probably have many children and live in small, cramped spaces

• Good at making ends meet with what they have .

• Make efforts and sacrifices to improve the lives and safety of their children.

Understand her life

HWWS Insights

• Wash only if hands are visibly dirty

• HWWS too complicated,

• Yet another burden

• Diarrhoea is part of growing up

Life Insights

• Family trusts them when it comes to managing the household and hygiene issues

• They feel nobody notices their efforts

•“I’m surviving”

Key messages for communication

“The hands to be proud of” and “Asante mama”

Rational: Handwashing is simple, easy and makes difference

Emotional:• The role of the mother is

recognized• They found solution and are less

burdens

Mother practising handwashing with soap

Strategy for communication

Mass Media (MM)Radio

Posters

Direct Consumer Contact (DCC)

Big Market day events, trading centers

Inter Personal Communication (IPC)

Volunteer work at markets, schools, health facilities,

churches, mosques, households

Materials

guidelines/manuals for Volunteers

Phases for behaviour change

Awaken & Inspire

Engage & Empower

Amplify Sustain

•Radio spot, call in show, DJ mentions•FLAs Training

•Radio Spot-how to make tippy taps•FLAs engaged, Materials •DCC-1st round

DCC -2nd round

National Sanitation campaign

MM Target: 14,597,800• As of November 2010– 14,533,300• 100% of Target

DCC Target: 171,300• As of October 2010– 327,264• 191% of Target

IPC Target: 320,000• As of June 2010 – 200,000• 63% of Target

Outputs

Outcome

• Rapid assessment and Impact assessment will be conducted from August 2011.

Spot check in Kiteto District Feb, 2011:

• Tippy tap as indicator

• Kiteto District has 3,498 house holds

• 18% of House holds has fuctioning tippy taps and soap.

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• Understanding the consumer is necessary to develop the right message, ways of communication and technology.

• The use of hand washing volunteers needs proper system for incentives within the Government structure.

• Performance monitoring need strengthening

• HWWS indicators included in MoH Results Framework mentioned in TZ Nationa Strategy for Growth and Poverty Reduction (NSGPR)

• Integtating Hand washing in National Sanitation Campaign from July 2011 for 42 Districts.

Lessons and way forward

• nmalimi@worldbank.org

• www.wsp.org/wsp/

Contact details and resources

THANK YOU!